Dr. Carol Rubin Associate Director for - PowerPoint Presentation

Slide1

Dr. Carol Rubin

Associate Director for Zoonoses and One HealthNational Center for Emerging and Zoonotic Infectious DiseasesCenters for Disease Control and Prevention

People Can Catch Diseases from Their Pets

Emerging Infectious Diseases

National Center for Emerging and Zoonotic Infectious Diseases

Emerging Infectious Diseases December 2012

Based on the article Surveillance of Zoonotic Infectious Disease Transmitted by Small Companion Animals

Michael J. Day , Edward

Breitschwerdt

, Sarah

Cleaveland

,

Umesh

Karkare

, Chand

Khanna

,

Jolle

Kirpensteijn

,

Thijs

Kuiken

, Michael R.

Lappin

, Jennifer

McQuiston

, Elizabeth Mumford, Tanya Myers,

Clarisa

B.

Palatnik

-de-Sousa, Carol Rubin, Gregg Takashima, and Alex

ThiermannSlide2

What is One Health?

One HealthA concept that takes into account the relationship among human health and animal health and the environmentPeople, animals, and environment are closely connected to each other.Movement of diseases from animals to humans can be influenced by changes in the environment they share.

An approach to looking at new diseases and other adverse health events by taking a holistic viewpoint that considers human health, animal disease, and environmental changesSlide3

What is One Health? (cont.)

No strict definition, some people might think that:One Health is a return to simpler times when most physicians were generalists rather than specialists, and physicians and veterinarians communicated regularly.One Health is especially important now because we live in a time when there is an increase in the number of new human diseases that

originate in animals.Slide4

What are zoonoses

?Zoonoses refer to diseases that pass between people and animals.Recently, researchers have determined that >70% of emerging infectious diseases in people actually come from animals.Some of these diseases start in wildlife that is being displaced by deforestation in remote areas of the world.

Diseases can move around the globe quickly because people and products, such as animals and food supplies,

are constantly crossing borders.Examples of new emerging infectious diseases:

viral hemorrhagic fevers, like Ebola respiratory

diseases, like SARSnovel influenza viruses, like pandemic H1N1What these serious diseases have in common is that they all start as zoonoses in the animal kingdom.Slide5

What are small companion animals?

Over centuries, animals have been domesticated by people who brought these animals into the home environment to share food and shelter. These animals are what we think of as ‘pets’.Nearly 1/3 of households in the United States have dogs and cats.

Many people live with less traditional pets, including reptiles, rodents, exotic birds, chickens, and arthropods, like tarantulas.These unusual pets pose different risks to human health and may require additional precautions.

Amphibians and reptiles normally have bacteria, like salmonella, that don’t cause illness in pets, but may cause illness in people. So people who own

pets, like frogs or lizards, should follow certain guideline when cleaning cages or tanks, especially when there are small children in the home.

Information about how to handle non-traditional pets can be found on CDC website.This article talks only about dogs and cats.Slide6

What are the zoonoses that can be transmitted to people by contact with cats and dogs?

Zoonoses that pass directly from dogs and cats to people:Diseases that move through animal bites or scratches, such asbacteria like Bartonella that cause cat scratch feverviruses that cause rabies

diseases like ringworm that are caused by fungi

Vector-transmitted (e.g., fleas, ticks, flies, mosquitoes) diseases for which cats and dogs may

act as reservoirs for the pathogenDiseases transmitted from animal feces when parasite eggs are inadvertently eaten by humans, such

asRoundworms, toxoplasmosis, coccidia, salmonellaDiseases transmitted from animal urine, like leptospirosisSlide7

What are reverse

zoonoses that cats and dogs might get infected with by close contact with people?Reverse zoonoses are diseases that do not normally occur in dogs and cats but can be passed from infected people to their pets, which can make them very sick.

e.g. tuberculosis, MRSA, fluSlide8

What is the public health role in dealing with zoonotic infections among small pets?

Local, state, and national public health officials seek to prevent human disease, and that includes zoonotic diseases.Ex: a child hospitalized because of Brucella canis, a bacteria seen in dogs.

When the child’s laboratory result was communicated to public health

officials, they: interviewed the family and determined that a puppy had recently been purchased from a pet store

.tested the dog, and traced the dog and the disease back to the pet store.

investigated where the dog originated and followed up with her littermates to see if the dog, or their owners, were sick. Brucella canis is required to be reported in only a few states, but astute physicians recognize that public health departments are a resource for even informal reporting of zoonotic diseases.Slide9

Do the zoonotic diseases

in pets have to be reported to any agency?For the most part, zoonotic diseases in dogs and cats are not reportable in the United States or elsewhere in the world, except for rabies.Rabies is required to be reported to state health authorities in the United States and in most developed countries.It needs careful follow-up to identify all humans who may have been exposed to an animal with rabies, or even an animal with suspected rabies.

Without treatment before symptoms appear, rabies is a fatal disease in people.All exposed persons are given post-exposure prophylaxis, which is medicine that prevents the rabies virus from spreading in the body.Slide10

Do the zoonotic diseases

in pets have to be reported to any agency? (cont.)Other zoonotic diseases reporting varies by state.Brucella canis is reportable in some states.

This disease is being watched as a possible increasing zoonotic problem so it’s possible that more states will require reporting.

Recently, the Council of State and Territorial Epidemiologists recommended that canine leptospirosis become a reportable disease because it appears to be occurring with increasing frequency in humans.Slide11

Is there any kind of surveillance system that monitors zoonotic diseases and infections in

pets?There is no organized surveillance system that counts the number or types of zoonotic diseases occurring in pets.Sick animals are often treated by independent veterinary clinics.Information regarding the diagnosis of a fairly minor

zoonoses is unlikely to be reported to any kind of surveillance system.That information should be communicated to the pet owner’s health care provider.

When veterinarians see an increase in the number of animals that come into a clinic with a zoonotic disease, it’s likely that the information will be communicated through informal networks.

Veterinary associations at city, state, national, and even international levels are an excellent way for veterinarians to communicate.The American Veterinary Medical Association and the World Small Animal Veterinary Association websites provide useful information to pet owners.Slide12

Is it possible to develop a viable surveillance system for pets, nationally and globally?

It’s important to consider ways to conduct surveillance for zoonotic diseases in pets.Pets share such a close relationship with humans. It’s of public health benefit to better understand disease transmission between pets and people.The likelihood of a successful

surveillance system increases as more veterinary clinics and hospitals switch to electronic medical records.An effective global network presents a major political, financial, and scientific challenge.Slide13

Should veterinarians be more aware of zoonotic diseases in pets?

Both veterinarians and physicians should be aware of zoonotic diseases.VeterinariansThey see pet owners in the same office with the pets so public health education about zoonoses can occur in a real time scenario.

They are trained to recognize zoonotic disease and may be the first health professional to recognize the occurrence of a zoonotic disease in a home or a community.

Without formal reporting systems, it’s important that veterinarians communicate potential health risks to the pet owner and also to

the owner’s physician.Slide14

Should veterinarians be more aware of zoonotic diseases in pets? (cont.)

PhysiciansIt’s important to ask about pets in the home as part of a patient’s health history.questions about the kind of pets and the health of those petsThere are so many positive outcomes to having

a pet in a home:Pets can provide strong emotional support.

Pets can provide personal protection or function as service animals.

Pets can be an impetus for humans getting more exercise.The process of taking care of a pet may make a person take better care of themselves.

The One Health approach encourages open lines of communication between physicians and veterinarians and local medical and veterinary associations.Slide15

What can pet owners do to protect themselves and their pets from zoonotic diseases?

Vaccinate pets, especially against rabiesProvide protection against external parasites like fleas and ticksTest and treat to control internal parasites

Periodic physical examinations for pets to increase likelihood that vaccinations and de-wormings are appropriately done

Contact a veterinarian for examination and treatment of a

newly adopted or rescued animals.Slide16

What can pet owners do to protect themselves and their pets from zoonotic diseases? (cont.)

Other common-sense precautions for pet owners:Removing feces from cat boxes dailyWashing hands after handling animalsNot handling animals that you are not familiar withAvoiding animals if you are immunosuppressedNot letting dogs drink from the toiletTrying to avoid being licked by animals

Avoid feeding raw meatWearing gloves when gardening, and washing hands thoroughly when finished gardeningNot sharing food utensils with pets

Clipping cat claws frequently to lessen the risk of scratchesMinimizing the interaction that your dogs or cats have with wildlife

e.g. should not leave pet food outdoors as that can attract wildlife, like raccoonsSlide17

For more information, please contact:

Emerging Infectious DiseasesCenters for Disease Control and Prevention1600 Clifton Road NE, Mailstop D61, Atlanta, GA 30333, USATelephone: 1-404-639-1960/Fax: 1-404-639-1954

E-mail: eideditor@cdc.gov Web: http://www.cdc.gov/eid/The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

National Center for Emerging and

Zoonotic Infectious Diseases

Emerging Infectious Diseases

Thank you to all authorsMichael J. Day , Edward Breitschwerdt, Sarah Cleaveland, Umesh Karkare, Chand Khanna, Jolle Kirpensteijn, Thijs Kuiken, Michael R. Lappin, Jennifer McQuiston, Elizabeth Mumford, Tanya Myers, Clarisa B. Palatnik-de-Sousa, Carol Rubin, Gregg Takashima, and Alex Thiermann